By HIMSS 2014, Epic Systems Corp. knew that health IT ratings researcher KLAS Enterprises LLC would be discontinuing the Best in KLAS Overall Software Vendor award for 2015. Upstart cloud vendor athenahealth Inc. had just knocked off Epic to capture this year's award, the first time a company other than Epic won since KLAS, more commonly known as KLAS Research, launched it in 2008.

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Athenahealth, however, didn't know about KLAS' decision until SearchHealthIT broke the story. In an interview, KLAS marketing director Larry Salazar said that, while the decision had been made to discontinue the category more than a year previous to athenahealth's win, the health IT research company had just begun notifying EHR vendors of the change last month.

Based on the sequence of events -- fueling conspiracy theories among HIMSS attendees about Epic's influence over KLAS -- Salazar conceded the situation could have been handled better.

"Obviously, we would have liked to have announced it on our own and not have it come out through a news report," said Salazar, who added that provider votes are typically so close that it would have been impossible to spot scoring trends a year in advance, determine that athenahealth would win the overall award and then act on that knowledge. "In hindsight, that probably would have been best."

The story behind KLAS' move

KLAS made the decision in the course of an annual evaluation of its award categories. Salazar said that company leadership makes additions and deletions after considering researcher input and opinions solicited from its medical advisory board. Current software categories can be seen here.

He continued by saying KLAS constantly adapts award categories based on constant conversations with thousands of healthcare providers. Right now, Salazar said, the market values more stratified product rankings based on narrower categories, or "tighter suites" of software more relevant to each provider's situation, i.e., inpatient, outpatient, hospital, specialty clinics, etc. Categories along those lines will replace the overall vendor award.

"They're thinking in groups [of products]," Salazar said, and not buying all software from an individual vendor. "An ambulatory vendor might also be thinking of an ambulatory practice-management piece, but they wouldn't necessarily say, 'I'm going to go buy clinical decision support from the same vendor.' They're going to look at it from a suite perspective … the overall award category is less relevant today, at least based on current research."

Athenahealth: KLAS retains value for customer engagement

Jeremy Delinsky, athenahealth CTO, said that KLAS' decision to delete the overall vendor award doesn't negate the accomplishment. "We were thrilled," Delinsky said. "That it's not a category next year doesn't diminish the fact that clearly something was different in the market this year for us to be recognized."

Obviously, we would have liked to have announced [the change in our vendor awards] on our own and not have it come out through a news report.

Larry Salazar, KLAS marketing director

That something athenahealth is banking on is spiking demand for health IT in the cloud, backed by services such as its aggregating of payer data. KLAS changes its categories frequently, Delinsky has noticed. For instance, his team was pleasantly surprised to learn they'd won the newly introduced patient portal award, a category it wasn't aware existed until after the company won it last January. That win put athenahealth over the top for best overall vendor.

Access to KLAS' research portal gives EHR vendors neutral-ground comparative data that helps them understand how they're faring versus competitors, said Jasmine Gee, athenahealth director of product marketing. She manages the vendor's relationship with KLAS by educating researchers on new products and features, setting budgets for research and assisting in customer interactions with KLAS.

Delinsky hopes KLAS won't be adding cloud vendor-specific awards anytime soon. Breaking it out in that fashion, he feels, takes away the head-to-head competition with traditional on-premises, client/server EHRs. "It doesn't make sense," he said. "You want to see how they compare to each other, rather than separately."

Nonparticipating EHR vendor CEO weighs in

Mark Hollis, CEO of MacPractice, said his company chooses not to subscribe to KLAS Research services, invest in research or participate in the awards process. The situation with the changing award categories doesn't particularly inspire him to reconsider that policy, either.

His Apple-centric health IT company, he said, prefers to devote its resources to directly interacting with its 15,000 solo and small family physician practices, optometrists, chiropractors and dentists.

"I haven't found it necessary," Hollis added. "I've been successful not doing it … and encouraging customers to talk to other customers similar to them, rather than some outside ranking."

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